Winter Preliminary Concussion Data Announced
May 3, 2016
By Geoff Kimmerly
Second Half editor
The Michigan High School Athletic Association has found through collection of preliminary data that fewer than two percent of its more than 70,000 winter student-athletes experienced potential concussions during the season that concluded in March.
The MHSAA this school year requested for the first time that member schools report possible concussions by their student-athletes during both practice and competition. A first set of preliminary data announced in December showed only two percent of more than 100,000 high school fall athletes experienced concussions during that first season of the 2015-16 school year.
As it did for the fall, the MHSAA again received data from more than 99 percent of its member high schools at the end of the winter season. The average number of possible winter concussions reported by member high schools through May 2, 2016, was 1.6 concussions per school – half the average per school reported for the fall season. Just more than 39 percent of reporting schools stated they had no concussions by athletes this winter.
Girls and boys basketball, by far the most popular winter sports by participation, also revealed the highest percentage of winter concussions. Girls basketball, with 22 percent of all winter athletes, revealed 38 percent of possible concussions. Boys basketball, with 30 percent of winter athletes, followed with approximately 20 percent of reported possible concussions. Wrestling, with 13 percent of winter athletes, also registered approximately 20 percent of possible concussions.
In addition to breakdowns by sport, the breakdown by gender this winter also was significant. Total, girls make up approximately 38 percent of athletes who compete during the winter season – and girls experienced 48 percent of the possible concussions reported.
“This second set of preliminary data continues to tell a story behind concussions that we anticipated,” MHSAA Executive Director John E. “Jack” Roberts said. “Most importantly, these findings show that concussions are affecting our female athletes just as much as our male athletes. Concussion care is not a football-focused issue, but something we must work to improve for both genders and across all sports. Eventually we will want to encourage and support research that might inform as to why, beyond differences in physiology, more concussions are reported for girls than for boys.”
Data collected by the MHSAA remains preliminary, in part, because results noted include pending reports that have not been verified. After completion of these follow-up reports, the final number of concussions that actually occurred this past season and during the fall may be lower than the preliminary numbers being reported at this time.
The data analyzed to date is for high schools only, although middle schools also have the opportunity to report possible concussions. A full breakdown of the data including concussions by gender, sport, team level (varsity through junior high) and setting (practice or event) will be reported after the conclusion of this spring 2016 season.
The reporting of possible concussions is part of a three-pronged advance by the MHSAA in concussion care during the 2015-16 school year which is producing data related to the frequency and severity of head injuries. The MHSAA this fall launched the largest ever state high school association sideline concussion testing pilot program, with 62 schools taking part by using one of two screening tests designed to detect concussions. One of the objectives of the pilot is to increase awareness of concussions and improve sideline detection; and preliminary results indicate that the average number of possible concussions reported by pilot schools exceeds the average reported by schools outside the pilot group.
Of 30 schools reporting the most possible concussions this winter, seven are part of the MHSAA’s pilot sideline detection programs. Those programs – King-Devick Test and XLNTbrain Sport – utilize technology to provide on-site testing of athletes who have sustained possible concussions, with results of those examinations then compared against baseline tests taken by athletes previously.
The MHSAA also is the first state association to provide all participants at every member high school and junior high/middle school with insurance intended to pay accident medical expense benefits – covering deductibles and co-pays left unpaid by other policies – resulting from head injuries sustained during school practices or competitions and at no cost to either schools or families. The program will produce additional data about the frequency and severity of head injuries. After the fall and winter seasons, only 110 claims have been made on the insurance policy designed to assist in payment for concussion care. Twenty-nine of the claims are for basketball (girls and boys combined), seven are for wrestling and five for injuries experienced during ice hockey activities.
Schools report possible concussions online via the MHSAA Website. Reports are then examined by members of the MHSAA staff, who follow up with school administrators as those student-athletes continue to receive care and eventually return to play. Student privacy is protected.
Previously, the MHSAA also was among the first state associations to adopt a return-to-play protocol that keeps an athlete out of activity until at least the next day after a suspected concussion, and allows that athlete to return to play only after he or she has been cleared for activity by a doctor (M.D. or D.O.), physician’s assistant or nurse practitioner. The follow-up reports schools are providing the MHSAA reveal that the majority of students are being withheld from activity for a week or longer following the reported concussion. This will be discussed in more detail when the MHSAA releases a more comprehensive review that covers the entire school year.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,400 public and private senior high schools and junior high/middle schools which exists to develop common rules for athletic eligibility and competition. No government funds or tax dollars support the MHSAA, which was the first such association nationally to not accept membership dues or tournament entry fees from schools. Member schools which enforce these rules are permitted to participate in MHSAA tournaments, which attract more than 1.4 million spectators each year.
Study: Single-Sport Athletes Injured More
November 3, 2016
A study conducted by the University of Wisconsin School of Medicine and Public Health and funded by the National Federation of State High School Associations (NFHS) Foundation revealed that high school athletes who specialize in a single sport sustain lower-extremity injuries at significantly higher rates than athletes who do not specialize in one sport.
The study was conducted throughout the 2015-16 school year at 29 high schools in Wisconsin involving more than 1,500 student-athletes equally divided between male and female participants. The schools involved in the study represented a mixture of rural (14), suburban (12) and urban (3) areas, and enrollments were equally diverse with 10 small schools (less than 500 students), 10 medium schools (501-1,000 students) and nine large schools (more than 1,000 students).
Athletes who specialized in one sport were twice as likely to report previously sustaining a lower-extremity injury while participating in sports (46%) than athletes who did not specialize (24%). In addition, specialized athletes sustained 60 percent more new lower-extremity injuries during the study than athletes who did not specialize. Lower-extremity injuries were defined as any acute, gradual, recurrent or repetitive-use injury to the lower musculoskeletal system.
“While we have long believed that sport specialization by high school athletes leads to an increased risk of overuse injury, this study confirms those beliefs about the potential risks of sport specialization,” said Bob Gardner, NFHS executive director. “Coaches, parents and student-athletes need to be aware of the injury risks involved with an overemphasis in a single sport.”
Among those who reported previously sustaining a lower-extremity injury, the areas of the body injured most often were the ankle (43%) and knee (23%). The most common types of previous injuries were ligament sprains (51%) and muscle/tendon strains (20%).
New injuries during the year-long study occurred most often to the ankle (34%), knee (25%) and upper leg (13%), with the most common injuries being ligament sprains (41%), muscle/tendon strains (25%) and tendonitis (20%).
In addition, specialized athletes were twice as likely to sustain a gradual onset/repetitive-use injury than athletes who did not specialize, and those who specialized were more likely to sustain an injury even when controlling for gender, grade, previous injury status and sport.
Thirty-four (34) percent of the student-athletes involved in the Wisconsin study specialized in one sport, with females (41%) more likely to specialize than males (28%). Soccer had the highest level of specialization for both males (45%) and females (49%). After soccer, the rate of specialization for females was highest for softball (45%), volleyball (43%) and basketball (37%). The top specialization sports for males after soccer were basketball (37%), tennis (33%) and wrestling (29%).
The study, which was directed by Timothy McGuine, Ph.D., ATC, of the University of Wisconsin, also documented the effects of concurrent sport participation (participating in an interscholastic sport while simultaneously participating in an out-of-school club sport), which indicated further risk of athletes sustaining lower-extremity injuries.
Almost 50 percent of the student-athletes involved in the survey indicated they participated on a club team outside the school setting, and 15 percent of those individuals did so while simultaneously competing in a different sport within the school. Seventeen (17) percent of the student-athletes indicated that they took part in 60 or more primary sport competitions (school and club) in a single year. Among those student-athletes in this group who sustained new lower-extremity injuries during the year, 27 percent were athletes who specialized in one sport.
The student-athletes involved in the study were deemed “specialized” if they answered “yes” to at least four of the following six questions: 1) Do you train more than 75 percent of the time in your primary sport?; 2) Do you train to improve skill and miss time with friends as a result?; 3) Have you quit another sport to focus on one sport?; 4) Do you consider your primary sport more important than your other sports?; 5) Do you regularly travel out of state for your primary sport?; 6) Do you train more than eight months a year in your primary sport?
Although some sports (field hockey, lacrosse) are not offered in Wisconsin and were not included in the study, the study concluded that since specialization increased the risk of lower-extremity injuries in sports involved in the survey it would also likely increase the risk of injuries in sports that were not a part of the study.